# Secondary use of EMR for residency training in asthma care and documentation

> **NIH NIH R21** · MAYO CLINIC ROCHESTER · 2020 · $198,750

## Abstract

PROJECT SUMMARY
Asthma is the most common chronic illness among children. In our preliminary study, we discovered significant
variations in the volume and quality of clinical documentation on asthma in electronic medical records (EMRs)
between pediatric residents and pediatric faculty. For example, although pediatric residents documented much
more extensively than the pediatric faculty on asthma-related histories consistent with a diagnosis of asthma,
the residents were less likely to make an actual diagnosis of asthma than their faculty counterparts. This
variation in documenting asthma-related events in EMRs has two important implications: one is a proficiency
issue related to the training of pediatric residents in achieving clinical competence in asthma care and
documentation; the other is a data quality issue, which impacts the secondary use of EMR for downstream
analyses. At present, little has been reported on the secondary use of EMR for residency training.
The primary goal of this proposed study is to develop an informatics tool assessing residents' adherence to
asthma guidelines (i.e., competence in asthma care) and documentation variation (i.e., competence in
documentation) (Aim 1) and evaluate individual pediatric resident's competence in asthma care and
documentation by conducting a population-based birth cohort study (Aim 2). The tool can be utilized to provide
“individualized clinical effectiveness data” for residents enhancing their clinical competence in asthma care, as
recommended by the Accreditation Council of Graduate Medical Education (ACGME).
In Aim 1: We will develop an automated informatics tool assessing adherence to asthma guidelines and
documentation variation in primary care settings. We will extract the necessary clinical elements from both
structured data querying from our database and unstructured data using natural language processing (NLP)
techniques to assess adherence to guidelines and documentation variation. The performance of element
extraction will be assessed against manual chart reviews as gold standard.
In Aim 2: We will evaluate clinical competence of pediatric residents in asthma care and asthma diagnosis. We
will assess clinical competence in asthma care for children with persistent asthma and examine clinical
competence in asthma diagnosis from clinical documentation using the informatics tool developed in Aim 1.
Expected outcomes: The proposed research is significant, innovative, and exploratory as little is known about
the secondary use of EMR for residency training. If successful, the study results will: a) deliver individualized
clinical effectiveness data report to pediatric residents to enhance their clinical training and documentation; and
b) provide an informatics tool assessing adherence to asthma care guidelines in clinical practice settings.

## Key facts

- **NIH application ID:** 9828754
- **Project number:** 5R21AI142702-02
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** YOUNG J JUHN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $198,750
- **Award type:** 5
- **Project period:** 2018-11-27 → 2022-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9828754

## Citation

> US National Institutes of Health, RePORTER application 9828754, Secondary use of EMR for residency training in asthma care and documentation (5R21AI142702-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9828754. Licensed CC0.

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